Bring on the Exercise, Hold the Painkillers – A Response

Bring on the Exercise, Hold the Painkillers – A Response

Guest written by Frank Hoeffner of our Roslyn clinic as commentary to The New York Times article “Bring on the Exercise, Hold the Painkillers,” July 6, 2017.

The New York Times article emphasizes that widespread use of Non-Steroid Anti-Inflammatory Drugs (NSAIDs) may not have the effect that people hope. A recent study showed that ibuprofen and other over-the-counter painkillers may create long-term risks to runners’ kidneys. It states that, “as many as 75 percent of long-distance runners take ibuprofen or other NSAIDs before, during or after training and races.”

The article references two recent studies that show NSAIDs working to reduce inflammation are potentially overtaxing the kidneys during exercise. This reduces the ability of the kidneys to produce prostaglandins that kick start blood vessel dilation and increase blood flow to the area, slowing recovery. In fact, some reports reveal that even “those who take the painkillers experience just as much muscle soreness as those who do not.”

As a Physical Therapist, I have seen many runners that rely on NSAIDs  in order to maintain their training routine.  Often times these runners require alterations to their training volume or have underlying pathologies that require attention.  I agree with the statements made in the article and that other methods such as ice, rest, and training alterations are better alternatives to NSAIDS. Over the years, I have found that chronic use of NSAIDs can interfere with a body’s normal response to tissue damage and healing. Prolonged use can also lead to gastrointestinal (GI) upset, and it taxes the internal organs required to metabolize these drugs. Someone who engages in intense physical activity will likely experience soreness along with some aches and pains. This should be considered normal. NSAIDs reduce the body’s natural inflammatory process. While commonly viewed in a negative fashion, the inflammatory response is a normal part of the body’s healing process and serves as a warning sign for injury. Taking NSAIDs will only interfere with the body’s normal processes and could mask a potential injury.

While there are certainly indications for the use of NSAIDs, people wishing to engage in vigorous exercise routines would be better inclined to enlist the services of a Physical Therapist who can assess for injury risk factors and design and monitor an appropriate exercise program. Physical Therapists have excellent knowledge of the body’s response to exercise and can make adjustments to variables such as intensity and volume to ensure a safe and effective workout.


To view the entire article click here.

Frank Hoeffner, PT
Regional Clinical Excellence Director – Queens/Long Island